Provider Demographics
NPI:1801609532
Name:ROBBERT, KASANDRA MARIE (RN)
Entity type:Individual
Prefix:
First Name:KASANDRA
Middle Name:MARIE
Last Name:ROBBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 URBAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4713
Mailing Address - Country:US
Mailing Address - Phone:720-933-7103
Mailing Address - Fax:
Practice Address - Street 1:7350 W EASTMAN PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5006
Practice Address - Country:US
Practice Address - Phone:720-376-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1638946163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse